Doctors today face a lot of challenges managing their practices. Undoubtedly they have acquired skills that are required to effectively run their operations apart from their core responsibility of providing patient services. At the cost of work-life balance in most of the cases. They are not only required to stay on top of changing protocols in their respective specialties, billing and coding but are also required to stay abreast of the technological advances to ensure they are providing better and right patient care.

Medical Billing today is not just about going and filling up a form. Considering the nitty-gritty’s of today’s billing processes, it takes an experienced medical billing professional to ensure compliance.

Billing was much simpler over two decades ago. There was information available way in advance about changing rules from the payers. In Today’s scenario, it is not surprising that claim rejection rate are increasing day by day, over 30 percent claim rejection rate in most of the cases and that requires extensive follow-up. Not many have a follow-up strategy either which leads to collection shortfalls.

Now what if these functions were managed by industry specialists who does nothing but billing and coding. Here are some of the reasons why I feel doctors outsourcing to a billing company makes a perfect sense.

• Managing Compliance: You get a dedicated work force that stays on top of ever changing regulations. This way you are not doing something that is not non-compliant.
• Certified Resources: Quite interestingly, Medical Billing & Medical Coding (for US) is one of chosen career options in countries like India. You can find certified staff with ease as against in the United States.
• Compliance Plans: For an individual practice, maintaining a compliance plan can be expensive compared to a professional billing company where the cost of a compliance office is spread across various clients. So, this maintaining compliance and reducing the cost both at the same time.
• Technology: A sizable amount of monies can drown into technology, especially in case of individual practices. Professional medical billing companies have already made their investments on this and some of them have created their own in-house billing platform which is offered for free with the billing services that they provide. These new platforms that have come up in the market are much advanced and are designed in such way that they can easily be modified in case of change in regulations, which is in-turn increasing the adaptability of the platforms.
• Follow-up Strategies: Lack of follow-up strategies on old and unpaid claims are resulting in huge loses for the doctors. Now why does this happen? The simple answer is, practices get busy dealing with the new one and they continue to keep the old unpaid claims aside. Obviously you need to take some time out for these. Time reminds me about timely filing, keep that in mind too.

All these cost the practice hundreds or thousands of dollars each year. I bet most don’t even realize how much they are leaving on the table. Physicians today are having to work much harder than ever before. I came across one of the surveys conducted which indicated a sizable percentage of doctors don’t recommend healthcare profession as a career option to the youngsters.

The Society of Human Resource Management states that the cost of recruiting, hiring, and training a new employee is $3,500. Utilizing a professional billing company eliminates this expense in its entirety. Professional billing companies today offer a range of pricing options, which makes their services less costly than if a practice tries to run its own internal operation.

In short, doctors can do what they do best and outsource the rest to a professional billing company who can do the work efficiently at a lower cost. After all the goal of a billing company is to maximize collections and ensure compliance.

Isn’t that your goal too???

Amit Kumar
Director Business Development
kumar@promantra.us